Khurana
Law Firm

Medicare whistleblower lawyer

Quit tam and whistleblower attorneys fighting Medicare and Medicaid fraud in Schaumburg, Illinois

Medicare and Medicaid fraud cost Illinois taxpayers billions of dollars annually. While many medical service providers and drug companies are ethical and work within the system, some don’t. When fraud takes place, everyone can lose. Medicaid and Medicare whistleblower lawyers can help healthcare workers to submit lawsuits on behalf of the government to help report this type of fraud.

The state and federal governments put a lot of trust in medical and pharmaceutical providers. When that trust is ill-placed, it counts on regular folks in Illinois to come forward and to report scams. People like you.

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Experienced Medicaid and Medicare whistleblower attorneys; representing healthcare workers in Schaumburg, Illinois

At Khurana Law Firm, P.C., as knowledgeable Medicare and Medicaid whistleblower lawyers, we support your heroic choice to come forward to report abuse and scams in the industry. We know that stepping forward is hard and numerous things may be at stake. When you come to us, your case is held in the strictest confidence at all times.

With our comprehensive experience representing whistleblowers nationwide, we completely investigate your claim, diligently prepare your case, for court, and work relentlessly with you and the federal or state government to help bring deceitful Medicaid or Medicare activity to justice.

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Whistleblower Laws in Schaumburg, Illinois

When an individual becomes aware of potentially fraudulent activity against the Illinois state government Medicaid program, they can submit a civil suit as whistleblowers under the Illinois False Claims Act.

 

This civil lawsuit, filed on behalf of the state government, holds those who perform deceitful activity liable for their misleading practices and recovers the financial loss to the state.

 

In addition to the Illinois False Claims Act, the Illinois Insurance Claims Fraud Prevention Act likewise permits individuals to come forward against fraud committed by private insurance companies.

 

State governments rely on people with knowledge of scams to come forward with that information in order to hold fraudulent activity in check and to punish those who commit those offenses. Because states usually have limited resources to find fraudulent activity on their own, the state rely heavily on individuals and will reward them in return.

 

If the state steps in and prosecutes the matter, a whistleblower can be granted between 15 and 25 percent of any recoveries. Even if the state opts not to step in and the whistleblower chooses to proceed on their own, that whistleblower stands to receive in between 25 and 30 percent of the recovery as a reward for their actions.

 

The Illinois False Claims Act likewise secures the whistleblower against retaliation when they have filed a claim against their employer.

Liability of the Defendant in Schaumburg, Illinois

In the state of Illinois, the offender can be held accountable for up to three times the actual harm inflicted to the state and may be required to pay extra fines of between $5,000 and $11,000 per violation.

Statute of Limitations in Illinois

There is a statute of constraints for the filing of a whistleblower claim by a private individual in Illinois. Plaintiffs must submit a suit within 10 years of the violation date in order to be considered for a whistleblower claim.

Working With an Experienced Whistleblower Attorney

If you are a healthcare worker in Schaumburg, Illinois and have learned about deceitful activity against the government, getting the legal guidance of an experienced whistleblower lawyer is crucial. At Khurana Law Firm, P.C., we are here to help. Contact us for a completely confidential, no-cost assessment to discuss your case.

What is

Medicare Advantage Fraud

Medicare Advantage (MA) plans are privately run healthcare options offering Medicare-eligible individuals additional services that are not included in traditional Medicare. These organizations receive payment from Medicare for each of their members that vary according to their risk adjustment. Some Medicare Advantage organizations overestimate and exaggerate a member’s risk or a patient’s diagnoses to get higher payments from Medicare. They do this by:

Upcoding

The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.

Chart reviews

The MA provider reviews charts to add additional diagnosis codes.

Chart mining

The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.

Adding unsupported diagnosis

Coders are directed to add codes based on other information in the chart.

Not removing old diagnosis codes

The MA provider increases the severity of the patient’s condition, submitting a more serious diagnosis code to get paid by Medicare at a higher rate.

Sham RADV audits

The MA provider reviews charts to add additional diagnosis codes.

Incentivizing doctors

The MA provider mines patient’s charts to look for conditions that are not current but can put as current to increase their payments from Medicare.

Pre-filling charts

Coders are directed to add codes based on other information in the chart.

If you suspect Medicare Advantage Fraud, you are a healthcare worker in Schaumburg, Illinois, get in touch with us here.

Khurana Law Firm, P.C.
Medicare Fraud
Medicare Fraud is a Serious Problem

While there are no exact figures concerning Medicare fraud, we do know it is a huge problem. In the fiscal year 2020, the government recovered over $1.8 billion in civil and fraud claims relating to the healthcare industry. 

$ 0
Recovered only in 2020
YOU, the healthcare worker, provide the most vital role in combating Medicare abuse and fraud.

Watching for fraud and abuse within your organization, practice, or provider’s office helps protect everyone from this taxpayer drain and holds abusers accountable.

So what is Medicare Fraud?

Fraud, as it relates to Medicare, is when individuals or entities make false statements or representations to benefit themselves at the expense of the Medicare program. 

Who defrauds Medicare?

Medicare fraud can involve numerous individuals, organizations, and entities, including physicians and nurses, physician-owned groups, drug companies, home health providers, medical device providers, nursing homes, and others.

How do people and companies commit Medicare fraud?

Fraud and abuse come in many different forms from coding abuses, to kickbacks, to altering records, to organized crime infiltration. Each method benefits the abuser while costing taxpayers billions. 

What laws protect Medicare from fraudulent activity?

The False Claims Act, Anti-kickback Statute, Stark Law, and Federal Criminal Healthcare Fraud Statute hold abusers accountable for their fraudulent activity. 

What government agencies protect against Medicare fraud?

Many government agencies strive to protect and promote the integrity of Medicare. These include the Centers for Medicare and Medicaid Services, Center for Program Integrity, US Department of Health and Human Services, and US Department of Justice, all attempting to keep Medicare fraud at bay. But they rely on people like YOU to be their eyes and ears.

How can I help?

If you see abuse and fraudulent activity you should report it. In some cases, you may even be entitled to a reward. If you are a healthcare worker in Schaumburg, Illinois,  you can report Medicare fraud when you contact the experienced whistleblower lawyers at Khurana Law Firm, P.C. for a confidential consultation. 

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WORKING WITH An Experienced WHISTLEBLOWER ATTORNEY; We are proud to represent healthcare workers in Schaumburg, Illinois

If you’ve become aware of fraud that may concern Medicare or Medicaid in Schaumburg, Illinois, you may need the advice of a skilled whistleblower lawyer, someone who can guarantee that your claim is totally examined and filed accurately and without delay. By dealing with an experienced attorney you are increasing the chance that the government will step in, thus increasing the possibility for a financial reward. Reporting Medicare and Medicaid scams is a complicated matter –  do not attempt to do this alone, we are here to help.

At Khurana Law Firm, P.C., we have years of practical experience as national qui tam lawyers to help in your fight against Medicare and Medicaid fraud. We will examine your case on a confidential, no-obligation basis. If we believe that you may have a valid claim, we can represent you in a qui tam claim to help report the fraud and allow you to gather a financial benefit. All whistleblower cases are on contingency, you pay absolutely nothing up until there is a settlement. Get in touch with us today to learn how we can be of help.

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